Skip to main content

Advertisement

Log in

Enhanced methods for visualizing myocardial perfusion with peripheral venous injection of Levovist®: Application of triggered harmonic imaging and triggered harmonic power Doppler imaging techniques

  • Published:
The International Journal of Cardiac Imaging Aims and scope Submit manuscript

Abstract

Objectives:The purpose of this study was to determine whether triggered harmonic imaging (THI) or triggered harmonic power Doppler imaging (THPDI) could obtain the myocardial contrast enhancement using peripheral venous injection of a first generation echocardiographic contrast agent, Levovist®. Methods:In a phantom model, we examined the influence of an acoustic power, harmonic filters, transmitted frequencies and focus positions of transducer on Levovist®. Then fundamental, harmonic or harmonic power Doppler imaging were performed with ECG-triggered imaging in eight closed-chest dogs using bolus injection of Levovist®. Results:In a phantom model, the highest transmission power (Mechanical index 1.6), a medium harmonic filter and a focus position (6 cm) resulted in the best enhanced contrast in both THI and THPDI. Furthermore, higher pulse repetition frequency (5500 Hz) of harmonic power Doppler made clearer enhancement. In animal models, we could not observe the apparent myocardial contrast using triggered fundamental imaging, and the intensity of each region of interest (ROI) of myocardium had not changed significantly. However, homogeneous myocardial contrast could be obtained using THI, which was conditioned on the highest transmission power, a medium harmonic filter same as the phantom model, at a lower transmitted frequency (1.8 MHz) and a focus position, which were located in the middle portion of the left ventricle. The peak intensity of each ROI increased significantly in a gray level. Furthermore, THPDI caused emphasized myocardial contrast visually. Conclusions:These results indicate that THI and THPDI produce obvious MCE using peripheral venous injection of Levovist®.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Armstrong WF, Mueller TM, Kinney EL, Tickner EG, Dillon JC, Feigenbaum H. Assessment of myocardial perfusion abnormalities with contrast-enhanced two-dimensional echocardiography. Circulation 1982; 66: 166-173.

    Google Scholar 

  2. Feinstein SB, Lang RM, Dick C, et al. Contrast echocardiography during coronary arteriography in humans: Perfusion and anatomic studies. J Am Coll Cardiol 1988; 11: 59-65.

    Google Scholar 

  3. Kemper AJ, O'Boyle JE, Cohen CA, Taylor A, Parisi AF. Hydrogen peroxide contrast echocardiography: Quantification in vivo of myocardial risk area during coronary occlusion and of the necrotic area remaining after myocardial reperfusion. Circulation 1984; 70: 309-317.

    Google Scholar 

  4. Ten Cate FJ, Drury JK, Meerbaum S, et al. Myocardial contrast two-dimensional echocardiography: Experimental examination at different coronary flow levels. J Am Coll Cardiol 1984; 3: 1219-1226.

    Google Scholar 

  5. Cheirif J, Zoghbi WA, Raizner AE, et al. Assessment of myocardial perfusion in humans by contrast echocardiography. I. Evaluation of regional coronary reserve by peak contrast intensity. J Am Coll Cardiol 1988; 11: 735-743.

    Google Scholar 

  6. Vandenberg BF, Feinstein SB, Kieso RA, Hunt M, Kerber RE. Myocardial risk area and peak gray level measurement by contrast echocardiography: effect of microbubble size and concentration, injection rate, and coronary vasodilatation. Am Heart J 1988; 115: 733-739.

    Google Scholar 

  7. Cheirif J, Zoghbi WA, Bolli R, O'Neill PG, Hoyt BD, Quinones MA. Assessment of regional myocardial perfusion by contrast echocardiography. II. Detection of changes in transmural and subendocardial perfusion during dipyridamole-induced hyperemia in a model of critical coronary stenosis. J Am Coll Cardiol 1989; 14: 1555-1565.

    Google Scholar 

  8. Porter TR, D'Sa A, Turner C, et al. Myocardial contrast echocardiography for the assessment of coronary blood flow reserve: validation in humans. J Am Coll Cardiol 1993; 21: 349-355.

    Google Scholar 

  9. Desir RM, Cheirif J, Bolli R, Zoghbi WA, Hoyt BD, Quinones MA. Assessment of regional myocardial perfusion with myocardial contrast echocardiography in a canine model of varying degrees of coronary stenosis. Am Heart J 1994; 127: 56-63.

    Google Scholar 

  10. Lim YJ, Nanto S, Masuyama T, et al. Coronary collaterals assessed with myocardial contrast echocardiography in healed myocardial infarction. Am J Cardiol 1990; 66: 556-561.

    Google Scholar 

  11. Sabia PJ, Powers ER, Jayaweera AR, Ragosta M, Kaul S. Functional significance of collateral blood flow in patients with recent acute myocardial infarction. A study using myocardial contrast echocardiography. Circulation 1992; 85: 2080-2089.

    Google Scholar 

  12. Ito H, Tomooka T, Sakai N, et al. Lack of myocardial perfusion immediately after successful thrombolysis: A predictor of poor recovery of left ventricular function in anterior myocardial infarction. Circulation 1992; 85: 1699-1705.

    Google Scholar 

  13. Porter TR, Xie F. Visually discernible myocardial echocardiographic contrast after intravenous injection of sonicated dextrose albumin microbubbles containing high molecular weight, less soluble gases. J Am Coll Cardiol 1995; 25: 509-515.

    Google Scholar 

  14. Meza M, Greener Y, Hunt R, et al. Myocardial contrast echocardiography: Reliable, safe, and efficacious myocardial perfusion assessment after intravenous injections of a new echocardiographic contrast agent. Am Heart J 1996; 132: 871-881.

    Google Scholar 

  15. Burns PN. Harmonic imaging with ultrasound contrast agents. Clin Radiol 1996; 51(suppl I); 50-55.

    Google Scholar 

  16. Starritt HC, Duck FA, Hawkins AJ, Humphrey VF. The development of harmonic distortion in pulsed finite-amplitude ultrasound passing through liver. Phys Med Biol 1986; 31: 1401-1409.

    Google Scholar 

  17. de Jong N, Ten Cate FJ, Lancee CT, Roelandt JR, Bom N. Principles and recent developments in ultrasound contrast agents. Ultrasonics 1991; 29: 324-330.

    Google Scholar 

  18. Schrope BA, Newhouse VL. Second harmonic ultrasonic blood perfusion measurement. Ultrasound Med Biol 1993; 19: 567-579.

    Google Scholar 

  19. Wei K, Skyba DM, Firschke C, Jayaweera AR, Lindner JR, Kaul S. Interactions between microbubbles and ultrasound: In vitro and in vivo observations. J Am Coll Cardiol 1997; 29: 1081-1088.

    Google Scholar 

  20. Porter TR, Xie F. Transient myocardial contrast after initial exposure to diagnostic ultrasound pressures with minute doses of intravenously injected microbubbles. Demonstration and potential mechanisms. Circulation 1995; 92: 2391-2395.

    Google Scholar 

  21. Porter TR, Xie F, Kricsfeld D, Armbruster RW. Improved myocardial contrast with second harmonic transient ultrasound response imaging in humans using intravenous perfluorocarbon-exposed sonicated dextrose albumin. J Am Coll Cardiol 1996; 27: 1497-1501.

    Google Scholar 

  22. Bude RO, Rubin JM, Adler RS. Power versus conventional color Doppler sonography: Comparison in the depiction of normal intrarenal vasculature. Radiology 1994; 192: 777-780.

    Google Scholar 

  23. Rubin JM, Bude RO, Carson PL, Bree RL, Adler RS. Power Doppler US: A potentially useful alternative to mean frequency-based color Doppler US. Radiology 1994; 190: 853-856.

    Google Scholar 

  24. Dymling SO, Persson HW, Hertz CH. Measurement of blood perfusion in tissue using Doppler ultrasound. Ultrasound Med Biol 1991; 17: 433-444.

    Google Scholar 

  25. Bude RO, Rubin JM. Power Doppler sonography. Radiology 1996; 200: 21-23.

    Google Scholar 

  26. Colon PJ III, Richards DR, Moreno CA, Murgo JP, Cheirif J. Benefits of reducing the cardiac cycle-triggering frequency of ultrasound imaging to increase myocardial opacification with FS069 during fundamental and second harmonic imaging. J Am Soc Echocardiogr 1997; 10: 602-607.

    Google Scholar 

  27. Villanueva FS, Glasheen WP, Sklenar J, Jayaweera AR, Kaul S. Successful and reproducible myocardial opacification during two-dimensional echocardiography from right heart injection of contrast. Circulation 1992; 85: 1557-1564.

    Google Scholar 

  28. Schrope B, Newhouse VL, Uhlendorf V. Simulated capillary blood flow measurement using a nonlinear ultrasonic contrast agent. Ultrason Imaging 1992; 14: 134-158.

    Google Scholar 

  29. Broillet A, Puginier J, Ventrone R, Schneider M. Assessment of myocardial perfusion by intermittent harmonic power Doppler using SonoVue, a new ultrasound contrast agent. Invest Radiol 1998; 33: 209-215.

    Google Scholar 

  30. Geny B, Mettauer B, Muan B, et al. Safety and efficacy of a new transpulmonary echo contrast agent in echocardiographic studies in patients. J Am Coll Cardiol 1993; 22: 1193-1198.

    Google Scholar 

  31. Feinstein SB, Cheirif J, Ten Cate FJ, et al. Safety and efficacy of a new transpulmonary ultrasound contrast agent: initial multicenter clinical results. J Am Coll Cardiol 1990; 16: 316-324.

    Google Scholar 

  32. Crouse LJ, Cheirif J, Hanly DE, et al. Opacification and border delineation improvement in patients with suboptimal endocardial border definition in routine echocardiography: Results of the Phase III Albunex Multicenter Trial. J Am Coll Cardiol 1993; 22: 1494-1500.

    Google Scholar 

  33. Kaul S, Senior R, Dittrich H, Raval U, Khattar R, Lahiri A. Detection of coronary artery disease with myocardial contrast echocardiography: comparison with 99mTc-sestamibi single-photon emission computed tomography. Circulation 1997; 96: 785-792.

    Google Scholar 

  34. Marwick TH, Brunken R, Meland N, et al. Accuracy and feasibility of contrast echocardiography for detection of perfusion defects in routine practice: Comparison with wall motion and technetium-99m sestamibi single-photon emission computed tomography. The Nycomed NC100100 Investigators. J Am Coll Cardiol 1998; 32: 1260-1269.

    Google Scholar 

  35. Wei K, Jayaweera AR, Firoozan S, Linka A, Skyba DM, Kaul S. Basis for detection of stenosis using venous administration of microbubbles during myocardial contrast echocardiography: Bolus or continuous infusion? J Am Coll Cardiol 1998; 32: 252-260.

    Google Scholar 

  36. Wei K, Jayaweera AR, Firoozan S, Linka A, Skyba DM, Kaul S. Quantification of myocardial blood flow with ultrasound-induced destruction of microbubbles administered as a constant venous infusion. Circulation 1998; 97: 473-483.

    Google Scholar 

  37. Hozumi T, Yoshida K, Abe Y, et al. Visualization of clear echocardiographic images with near field noise reduction and technique: Experimental study and clinical experience. J Am Soc Echocardiogr 1998; 11: 660-667.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hirooka, K., Miyatake, K., Hanatani, A. et al. Enhanced methods for visualizing myocardial perfusion with peripheral venous injection of Levovist®: Application of triggered harmonic imaging and triggered harmonic power Doppler imaging techniques. Int J Cardiovasc Imaging 16, 233–246 (2000). https://doi.org/10.1023/A:1026592629450

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1026592629450

Navigation